Ménière’s Disease
Ménière’s disease is a vestibular disorder caused by a buildup of inner ear fluid called endolymph. The four classic symptoms are vertigo, tinnitus, a feeling of fullness or pressure in the ear, and fluctuating hearing. Ménière’s disease can also co-exist with Vestibular Migraine.
What causes Ménière’s disease?
The exact cause of Ménière’s disease is unknown. However, the fluid build-up inside the inner ear interferes with signals the brain receives causing vertigo, hearing loss, tinnitus, and pressure.
What are the symptoms of Ménière’s disease?
Ménière’s often affects one ear only and is progressive. It may start out with occasional fluctuations in hearing and occasional episodes of dizziness. Attacks can last 20 minutes or as long as 24 hours. Patients usually report feeling quite tired immediately after an attack but often feel well between attacks. During an attack of spinning vertigo, usually the feeling of pressure increases, tinnitus increases, and hearing decreases. The symptoms may go away after the attack but the hearing loss and tinnitus may become permanent as the disease progresses.
How is Ménière’s Disease Diagnosed?
An Ear Nose and Throat Specialist (ENT) is the medical professional to diagnose Ménière’s disease and may request imaging and blood tests to medically rule out other disorders which may mimic Ménière’s. If Ménière’s is suspected, the following testing is important in the diagnosis:
Audio-vestibular testing assesses the integrity of the inner ear hearing and balance sensors and nerves that may be affected by Ménière’s disease and include:
- Videonystagmography (VNG);
- Vestibular evoked myogenic potentials (VEMPS); and
- Video Head Impulse Testing (vHIT)
Diagnostic hearing testing and audiological monitoring over time are also important in a Ménière’s diagnosis as fluctuating hearing is a significant sign of Ménière’s Disease.
What is the treatment for Ménière’s:
No cure exists for Ménière’s disease. However, a number of medical treatments can help reduce the severity and frequency of vertigo episodes.
Medications: Medications for motion sickness and nausea are often prescribed. Diuretics to reduce fluid in the ear or steroids to reduce inflammation are often used. Medications can also be injected into the middle ear to help improve vertigo symptoms.
Hearing aids: Hearing aids are often prescribed to treat hearing loss.
Vestibular Rehabilitation Therapy (VRT): Vestibular rehabilitation therapy is recommended if balance problems persist between episodes.
Tinnitus Retraining Therapy (TRT): Tinnitus retraining therapy is recommended if persistent, bothersome tinnitus persists between episodes.
Lifestyle Management: Ménière’s management may involve lifestyle measures such as changes to diet, sleep, exercise, or stress. Limiting salt is often advised.
